title: Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment.
abstract: Small bowel adenocarcinomas are rare tumours, but their incidence is increasing. Their most common primary location is the duodenum. The few studies that have collected data regarding small bowel adenocarcinoma are not homogeneous and are widely spread over time. Even though these tumours are most often sporadic, some predisposing diseases have been identified, among which Crohn's disease and genetic syndromes. Early diagnosis of small bowel adenocarcinoma remains difficult despite significant radiological and endoscopic progress. After surgical resection the main prognostic factor is node invasion; in this case, adjuvant chemotherapy can be expected to be beneficial, although this has not been established by randomised trials. For metastatic disease, platinum-based chemotherapy seems to be the most effective treatment. Targeted therapies have not yet been evaluated in this type of cancer.
authors.affiliation: Gastroenterology and Digestive Oncology Unit, Avicenne Hospital, HUPSSD, APHP, Université Paris 13, Sorbonne Paris Cité, Bobigny, France. Electronic address: thomas.aparicio@avc.aphp.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Aparicio
authors.affiliation: Gastroenterology and Digestive Oncology Unit, Georges Pompidou Hospital, APHP, Paris, France; UMR-S775, INSERM, Paris, France.
authors.forename: Aziz
authors.initials: A
authors.lastname: Zaanan
authors.affiliation: Anatomopathology Unit, Saint Antoine Hospital, APHP, Paris France.
authors.forename: Magali
authors.initials: M
authors.lastname: Svrcek
authors.affiliation: UMR-S775, INSERM, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Laurent-Puig
authors.affiliation: Digestive Surgery Unit, Purpan Hospital, Toulouse, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Carrere
authors.affiliation: Hepato-Gastroenterology Unit, Pontchaillou Hospital, Rennes, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Manfredi
authors.affiliation: Hepato-Gastroenterology Unit, Meaux Hospital, Meaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Locher
authors.affiliation: Oncology Unit, Saint Antoine Hospital, APHP, Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Afchain
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011125:Adenomatous Polyposis Coli / Q000235:genetics; D000428:Alcohol Drinking / Q000453:epidemiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002446:Celiac Disease / Q000453:epidemiology; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics; D003424:Crohn Disease / Q000453:epidemiology; D013505:Digestive System Surgical Procedures; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D020022:Genetic Predisposition to Disease; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007580:Jejunal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D010580:Peutz-Jeghers Syndrome / Q000235:genetics; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Carcinogenesis; Chemotherapy; Lynch syndrome; Prognostic factor; Rare tumour; Small intestine adenocarcinoma